A nationwide shortage of Adderall has left many people with attention-deficit/hyperactivity disorder (ADHD) struggling to find medication that they rely upon.
The U.S. Food and Drug Administration blames the shortage on manufacturing problems at one major producer, Teva.
In deconstructing this problem, we can find a hint at the source via a report from CNYhomepage:
Dr. David W. Goodman, an assistant professor in psychiatry at the Johns Hopkins School of Medicine, says there has also been an increase in awareness about ADHD among both patients and physicians. He says that’s driving up demand.
“So they seek an evaluation, and more and more prescribers are comfortable enough to make a diagnosis and prescribe a medication,” Goodman said.
His advice for patients is not to panic.
“If it’s necessary, call your prescriber and see if there’s an alternative dose that can bridge you until you can get back on the dose that you’re prescribed,” Goodman said.
Did you notice anything strange in that quote? I did. It jumped out at me. The quoted doctor, a psychiatrist, is advising people to call their “prescriber,” not their doctor. This requires us to ask, what the f**k is a “prescriber.”
According to 42 CFR § 423.15, “Prescriber means a physician, dentist, or other person licensed, registered, or otherwise permitted by the U.S. or the jurisdiction in which he or she practices, to issue prescriptions for drugs for human use.”
It’s important to note that, in the US, Adderall is a Schedule II substance (along with the likes of Ambien, Xanax, etc.). This means that it’s heavily regulated and controlled. As such, technically it’s required that you see an in-person doctor to be diagnosed and prescribed. However, because of the COVID-19 pandemic, these restrictions have been lifted by the DEA … supposedly in an effort to protect the nation’s prescription supply chain.
If there was any silver lining to the pandemic, it’s that tele-health became more accessible and affordable than ever. And the nationwide Public Health Emergency that was put into effect in the US has made tele-health more robust than ever before. So whilst you can’t just “buy” Adderall online, you can go through the normal process of diagnostics, treatment, and receiving prescription medication entirely online.
But, as always, when government creates a convenient opening, problems tend to occur. For example, pharmacies across the US have started blocking or delaying prescriptions from tele-health companies (including Done and Klarity) over concerns that doctors are over-prescribing ADHD medications such as Adderall. Because of this, filling on-line prescription may be difficult.
Done ADHD has a 2.8 of 5 star rating with more than 2,100 reviews on consumer review site Trustpilot. Most of the negative reviews concern prescriptions being filled. On the Better Business Bureau (BBB), Done ADHD has a 1.07 of 5 star rating based on nearly 80 reviews. Complaints are mostly from users who said they were charged the first month fee of $199, only to never receive their medication and received minimal or no help from the company. Many were unhappy with how long it took for prescriptions to be filled and how long it took for Done ADHD to respond to prescriptions that were denied, and some with the overall process (source).
Klarity is no better. It received an “F” rating from the BBB.
I have to admit here that I’ve never been a fan of giving “speed” to “manage” ADHD. I’m aware that many people swear by it and claim it provides “relief” of their “symptoms.” This opinion was likely influence with my own medical journey. When my parents were seeking to find why I had so much energy and couldn’t seemingly stay on task, my doctor suggested an early (1970’s) version of the current concoction. Thankfully, my grandmother found a doctor for me who saw this high energy as a strength, and began the instruction on how to leverage these varying energy states to great effect.
In the modern sense, going to most tele-health “prescribers” is akin to going to your local weed dealer to ask them if weed might help with whatever is ailing you. Of course they will sell you weed to manage your symptoms. That’s their job … to sell weed. They have no financial interest in not selling you what your heart desires. Doctors, or providers, in this sense are nothing more that legal drug dealers.
So, with all of this in mind, it should come as no surprise that Adderall is in short supply. Easy access, combined with a huge increase in new prescriptions, combined with a pandemic that reduced shipments of raw materials, has meant difficulty in keeping up with demand. Unfortunately, the shortage is not going away soon.